Incidental finding of significantly narrowed airway

I spotted this today whilst looking for a cause of mild right sided submandibular pain. It's probably unrelated. When I questioned the 31 year old patient he felt he was increasingly short of breath over the last year but put that down to inactivity during Covid19, and being a bit of a smoker. In fact the picture clearly shows a subglottic narrowing, perhaps 50% of the breathing tube. He may need surgery.